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Understanding Mental and Substance Use Disorders Across the United States

Filling gaps in the data on individuals with mental and substance use disorders and their treatment

Mental and substance use disorders are significant public health problems in the United States, with substantial unmet treatment need. To help allocate service resources, we need better estimates of how many people are affected by these problems and whether they have received treatment.

Two gaps in our understanding of mental and substance use disorders are particularly important: 

  • The lack of accurate estimates of the most seriously impairing disorders in household populations, such as schizophrenia; 
  • The exclusion of the incarcerated, homeless, and hospitalized non-household populations from national estimates. 

The National Study of Mental Health (NSMH) is designed to fill these gaps. This three-year study aims to provide national estimates of mental health and substance use disorders among U.S adults ages 18 to 65. These include schizophrenia or schizoaffective disorder, bipolar disorder, major depression, posttraumatic stress disorder, obsessive-compulsive disorder, generalized anxiety disorder, and alcohol, benzodiazepine, opioid, stimulant, and cannabis use disorders. The study is also designed to estimate what proportion of individuals with mental and substance use disorders receive treatment. 

Our Methodology

RTI is carrying out the NSMH with funding from the Substance Abuse and Mental Health Services Administration. The study is based on interviews conducted by clinicians to assess complex and impairing disorders. 

Our data collection effort is divided into two samples: households and non-households. For the household sample, our team will identify eligible respondents in households in chosen areas across the country. Selected adults will be asked to complete a short screening instrument. This screening instrument will help the study team identify individuals likely to have mental or substance use disorders to prioritize for a clinical interview. We will conduct clinical interviews by video conference, telephone, or in person. 

The NSMH non-household sample includes people in federal and state prisons, homeless shelters, and state psychiatric hospitals. Facility records will be used to select potential respondents. All interviews with individuals from these non-household settings will be conducted by video conference, telephone, or in person.  Put together, the household and non-household samples will present a comprehensive picture of mental and substance use disorders across the country. We are choosing areas and facilities based on their particular characteristics and relevance to meeting the study objectives. We are conducting interviews in English or Spanish and keeping data confidential. Names of individuals, facilities and agencies will never be released nor linked to the data.

The study began in October 2019. After devoting year one to planning, we moved on to data collection in year two. Due to the COVID-19 pandemic, data collection began with web, phone, and video interviews. In-person data collection is planned to begin in the summer of 2021.  In the third and final project year, we will complete data collection, generate estimates of mental and substance use disorders, prepare reports, and deliver data sets to SAMHSA.

Paving the Way for Further Research on Mental Health and Substance Use Disorders

A secondary goal of the NSMH is to consider the best research methods for doing studies like this in the future. Study findings will help determine the treatment and service needs of individuals with mental health and substance use disorders. With this knowledge, we can better allocate resources that help individuals successfully manage their mental and substance use problems.

Learn More

The National Study of Mental Health (NSMH) is a research effort that will provide critical information on mental health and health behaviors in the United States.

Visit the study website